BVA9501010
DOCKET NO. 91-17 528 ) DATE
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On appeal from the decision of the
Department of Veterans Affairs Regional Office in New Orleans,
Louisiana
THE ISSUES
1. Entitlement to service connection for right hip and neck pain
secondary to Ehlers-Danlos syndrome.
2. Entitlement to service connection for sinusitis.
3. Entitlement to an increased rating for mechanical low back
pain secondary to Ehlers-Danlos syndrome, currently rated as
20 percent disabling.
4. Entitlement to an increased (compensable) rating for left hip
pain secondary to Ehlers-Danlos syndrome.
REPRESENTATION
Appellant represented by: Disabled American Veterans
WITNESS AT HEARING ON APPEAL
Appellant
ATTORNEY FOR THE BOARD
Michael P. VanderMeer, Associate Counsel
INTRODUCTION
The veteran served on active duty from December 1987 to April
1989.
This case is before the Board of Veterans' Appeals (Board) on
appeal from a September 1989 rating decision of the Department of
Veterans Affairs (VA) Regional Office (RO) in New Orleans,
Louisiana. This case was last before the Board in January 1994,
at which time it was remanded for further development.
The appeal was returned to and redocketed at the Board in April
1994.
REMAND
On review of the file it is noted that a hearing officer's
decision dated in August 1992, pertaining to a hearing held in
April 1992, reflects that the veteran had, in conjunction with
her personal hearing, submitted reports reflecting treatment
rendered her from August 24, 1990, to April 21, 1992, at
Barksdale Air Force Base Hospital as well as a lumbar spine
magnetic resonance imaging report, which was noted by the hearing
officer to have been indicative of lumbar disc herniation, from
Willis-Knighton Medical Center dated April 20, 1992. While the
transcript of the veteran's April 1992 hearing, at which she
indicated having received treatment at the Barksdale facility for
a sinus condition and which treatment is of possible implication
for her current claim for service connection for sinusitis, was
obtained and associated with the claims folder pursuant to the
Board's January 1994 remand, neither the above-addressed
Barksdale records nor the magnetic resonance imaging report from
the Willis-Knighton facility, which latter report may bear on the
veteran's current claim for an increased rating for mechanical
low back pain, are shown to be of record. Further development in
this regard is specified below.
At her personal hearing, with respect to her claim for an
increased rating for mechanical low back pain, the veteran's
complaints relative to her low back included diminished ability
to flex forward as well as experiencing back spasms. Given the
veteran's recent hearing testimony, and inasmuch as her low back
has not been X-rayed by VA since August 1990, the Board is of the
opinion that a current VA examination should be performed before
an appellate adjudication of the veteran's claim for an increased
rating for mechanical low back pain is rendered. The Board is
similarly of the opinion that a current VA examination in
conjunction with the veteran's claim for an increased rating for
her service-connected left hip pain should be performed before a
related decision on appeal is made.
Accordingly, the case is REMANDED for the following:
1. The RO should contact the veteran and
request her to identify the names,
addresses, and approximate dates of
treatment for any health care provider(s)
to include any VA medical facility other
than the VA Medical Center in Shreveport,
Louisiana, as well as possible treatment
rendered the veteran subsequent to
April 21, 1992, at Barksdale Air Force Base
Hospital, who may possess additional
records pertinent to her claims.
Thereafter, in light of the response
received and after obtaining any necessary
authorization, the RO should take
appropriate action to obtain copies of any
clinical records indicated. In any event,
the RO should obtain copies of all clinical
records reflecting treatment rendered the
veteran since April 1992 at the VA Medical
Center in Shreveport, Louisiana; and, after
obtaining any necessary authorization, the
RO should obtain and/or associate with the
claims folder a lumbar spine magnetic
resonance imaging report from Willis-
Knighton Medical Center dated April 20,
1992, as well as all clinical reports
pertaining to treatment rendered the
veteran from August 24, 1990, to April 21,
1992, at Barksdale Air Force Base Hospital.
2. Thereafter, the RO should arrange for
the veteran to undergo a VA examination by
a board certified orthopedist, if
available, to determine the current
severity of her service-connected
mechanical low back pain and service-
connected left hip pain. Findings
pertaining to range of motion of the
veteran's lumbar spine and left hip are
essential. Any special diagnostic studies
deemed necessary should be performed, and
the claims folder must be made available to
the examiner for review prior to the
examination.
3. The RO should then review the report
pertaining to the VA examination performed
in response to the previous directive to
ascertain whether such examination is in
compliance with the Board's examination
instructions.
4. Then, after undertaking any development
deemed necessary in addition to that
specified above, the RO should readjudicate
the issues on appeal.
5. If the benefits sought on appeal are
not granted to the veteran's satisfaction,
the veteran and her representative should
be provided a Supplemental Statement of the
Case on all issues in appellate status.
The veteran should be provided appropriate
notice of the requirements to perfect an
appeal with respect to any issue addressed
therein, which does not appear on the title
page of this decision.
Thereafter, the case should be returned to the Board for further
appellate consideration, if otherwise in order. In taking this
action, the Board implies no conclusions, either legal or
factual, as to any ultimate outcome warranted. No action is
required of the veteran until she is notified.
ROBERT E. SULLIVAN
Member, Board of Veterans' Appeals
The Board of Veterans' Appeals Administrative Procedures
Improvement Act, Pub. L. No. 103-271, § 6, 108 Stat. 740, ___
(1994), permits a proceeding instituted before the Board to be
assigned to an individual member of the Board for a
determination. This proceeding has been assigned to an
individual member of the Board.
Under 38 U.S.C.A. § 7252 (West 1991), only a decision of the
Board of Veterans' Appeals is appealable to the United States
Court of Veterans Appeals. This remand is in the nature of a
preliminary order and does not constitute a decision of the Board
on the merits of your appeal. 38 C.F.R. § 20.1100(b) (1993).